Hamstring Braid Graft Technique for Anterior Cruciate Ligament Reconstruction

Abstract

Hamstring autograft is one of the most used grafts for anterior cruciate ligament (ACL) reconstruction, although there are several graft preparation techniques. It is extremely difficult to mimic the biomechanical properties of the native ACL; thus, it is important to achieve a proper graft configuration, diameter, and length. To avoid reruptures, an optimal and reproducible hamstring autograft is desired. Hamstring autograft has been traditionally devalued when compared with other options such as bone–patellar tendon–bone autograft. The purpose of this Technical Note is to describe in detail a hamstring braid graft configuration that could potentially overcome the past disadvantages of ACL reconstruction.

Video-Based Computer Aided Arthroscopy for Patient Specific Reconstruction of the Anterior Cruciate Ligament

“…Since arthroscopy largely preserves the integrity of the articulation, it is beneficial to the patient in terms of reduction of trauma, risk of infection and recovery time [17]. However, arthroscopic approaches are more difficult to execute than the open surgery alternatives because of the indirect visualization and limited manoeuvrability inside the joint, with novices having to undergo a long training period [14] and experts often making mistakes with clinical consequences [16]. The reconstruction of the ACL illustrates well the aforementioned situation.…”

“…The reconstruction of the ACL illustrates well the aforementioned situation. The ACL rupture is a common medical condition with more than 200 000 annual cases in the USA alone [16]. The standard way of treatment is arthroscopic reconstruction where the torn ligament is replaced by a tissue graft that is pulled into the knee joint through tunnels opened with a drill in both femur and tibia [3].…”

“…Unfortunately, ligament position varies significantly across individuals and substantial effort has been done to model variance and provide anatomic references to be used during surgery [5]. However, correct tunnel placement is still a matter of experience with success rates varying broadly between low and high volume surgeons [16]. Some studies reveal levels of satisfaction of only 75% with an incidence of revision surgeries of 10 to 15%, half of which caused by deficient technical execution [16].…”

“…However, correct tunnel placement is still a matter of experience with success rates varying broadly between low and high volume surgeons [16]. Some studies reveal levels of satisfaction of only 75% with an incidence of revision surgeries of 10 to 15%, half of which caused by deficient technical execution [16]. This is a scenario where Computer-Aided Surgery (CAS) can have an impact.…”

Anterior Cruciate Ligament Reconstruction Using Combined Graft of Hamstring and Fascia Lata With Extra-articular Tenodesis. A Technique in Case of Insufficient Hamstrings

“…Several resources could be employed to increase the diameter of the hamstring graft. 6 , 7 These maneuvers provide a shorter but wider graft; however, in a few cases, the diameter of the graft may still remain small. The aim of this article is to describe a technique for ACL reconstruction and lateral extra-articular tenodesis (LET) using a triple hamstring graft and a long strip of fascia lata for LET and ACL hamstring graft augmentation.…”